動靜脈瘻管功能不良及失效,會影響末期腎病病人執行血液透析的效率,增加罹病率與死亡率。因此,如何維持瘻管通暢及功能是重要照護議題。本研究以系統性文獻回顧探討遠紅外線照射對瘻管血流量、通暢率及失效率之成效。以關鍵字搜尋中英文次級及初級資料庫,共納入3篇隨機對照試驗及2篇系統性文獻回顧,以Review manager 5.2分析遠紅外線治療之成效,一年後瘻管失效率的勝算比(OR)=0.35, 95% CI [0.22, 0.55], p<.00001;瘻管通暢率OR=2.12, 95% CI[1.44, 3.11], p=.0001;瘻管血流量照射前後之差異,實驗組較控制組在一年後平均差(MD)為129.62ml/min, 95% CI [73.05, 186.18], p< .00001。此結果支持將遠紅外線照射列為瘻管的保養措施之一,應建立儀器操作規範及標準流程,加強病人使用安全。
Malfunction of arteriovenous fistula (AVF) affects patients with end-stage renal disease and increases the rates of morbidity and mortality. Therefore, maintenance of AVF patency is a crucial concern. The objective of this systematic review was to explore the effectiveness of far-infrared therapy on AVF blood flow, patency, and malfunction. Chinese and English secondary and primary databases were searched using relevant keywords; subsequently, three randomized controlled trials (RCTs) and two systematic review studies were shortlisted. Data from the three RCTs were included in the meta-analysis, pooled and evaluated using Review Manager 5.2. The pooled odds ratio (OR) for AVF malfunction and AVF patency were 0.35 (95% confidence interval (CI) [0.22, 0.55], p<.00001), and 2.12 (95% CI [1.44, 3.11], p=.0001), respectively; blood-flow velocity mean difference (MD) was 129.62mL/min, (95% CI [73.05, 186.18], p<.00001) after 1 year in the experimental group. The findings support previous results that revealed improvement in fistula maintenance through far-infrared therapy. Establishing operational procedures and standards increased patient safety.